VICTORIAN SQUARE LLC NPI 1710180955

NPI Information

  • NPI: 1710180955
  • Provider Name: VICTORIAN SQUARE, LLC
  • Classification: Assisted Living Facility - 3104A0625X
  • Specialization: Assisted Living, Mental Illness
  • Entity Type: Organization
  • Doing Business As: VICTORIAN SQUARE ASSISTED LIVING FACILITY
  • Address: 241 S CHAMBERLAIN AVE
    ROCKWOOD, TN
    ZIP 37854
  • Phone: (865) 354-1133

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NPI Details

VICTORIAN SQUARE, LLC is an assisted living and mental illness assisted living facility in Rockwood, TN. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. VICTORIAN SQUARE, LLC NPI is 1710180955. The provider is registered as an organization entity type.
The provider Is Doing Business As Victorian Square Assisted Living Facility.

The provider's business location address is:

241 S CHAMBERLAIN AVE
ROCKWOOD, TN
ZIP 37854-542
Phone: (865) 354-1133
Fax: (865) 354-6371

The provider's authorized official is Ralph H Bellande .
The authorized official title is Managing Partner and has the following contact phone number (502) 228-8131.

The enumeration date for this NPI number is 6/6/2007 and was last updated on 1/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessACL0000000147TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14262690OTHERTENNESSEETENNCARE/MEDICAID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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